Update (Nov. 16, 2018): This rule has been finalized as proposed. Beginning January 1, 2019, health centers will be able to bill for these services. NACHC is hosting a webinar on Thursday, November 29, 2018 at 1 pm ET with the Centers for Medicare & Medicaid Services and health center partners to learn more about these …
Category: Health Center Regulatory Issues
A New Medicare Shared Savings Proposed Rule Could Affect Health Centers
The Centers for Medicare and Medicaid Services (CMS) has released a proposed rule that would transform their Medicare Shared Savings Program (MSSP), pushing accountable care organizations (ACOs) to take on increasing levels of financial risk. CMS’s proposal, which it is calling “Pathways to Success,” would consolidate and streamline the ACO track options; require that participating …
Confidentiality and Medical Records: Do Special Protections Apply?
Since the 1970s, the Federal Government has required that the medical records of patients who receive treatment for substance use disorder (SUD) be given extra protections to ensure confidentiality. These federal rules – commonly known as 42 CFR Part 2 – have recently been revised, and are more extensive than the standard protections required under …
CMS Issues Guidance on Community Engagement and Work Requirement Proposals for Medicaid
Today CMS published its much anticipated federal policy guidance (SMD: 18-002, see NACHC summary here) reiterating its support and describing considerations for states with an interest in pursuing Section 1115(a) Medicaid waivers to implement work and/or community engagement requirements for Medicaid. This effort began last year with a letter from then-Secretary Price and CMS Administrator …
CMS Releases Rule That Improves Care for Health Center Medicare Patients
The Centers for Medicare and Medicaid Services (CMS) released its final rule on the CY2018 Physician Fee Schedule earlier this month. While this annual rule typically does not impact services for Community Health Centers (because they are not paid on the Physician Fee Schedule), this year’s rule includes some important provisions that boost care for health center …
CMS Issues Informational Bulletins on Waiver Processes
The Centers for Medicare and Medicaid Services’ (CMS’) Center for Medicaid and CHIP Services (CMCS) has issued two informational bulletins on changes to the Section 1115 Medicaid waiver process and State Plan Amendment and 1915 waiver process. The informational bulletins are a follow-up to a March 14 letter from CMS Administrator Seema Verma and then-HHS Secretary …
MACPAC Takes a Look at Health Centers
[UPDATED] Medicaid and CHIP Payment and Access Commission (MACPAC) has released an issue brief on Medicaid payments and health centers as a follow up to their session on “Considering Medicaid Payment to FQHCs” earlier this fall. As background, MACPAC is a non-partisan agency that provides analysis for Congress on Medicaid and CHIP issues including payment, eligibility, enrollment access and quality …
House Subcommittee Focuses on the 340B Program
While other health care related issues have certainly taken up much of the space on Congress’ agenda over the past year, the 340B program can be added to the list of issues at which Congress has taken a closer look at over the past several months. A case in point is the House Energy and Commerce …
Update on MACRA Implementation
By now many of you have heard of the new Medicare Quality Payment Program (QPP), born out of the Medicare and CHIP Reauthorization Act of 2015 (MACRA) that went into effect this year. The QPP completely revamps the way Medicare pays its providers and is made up of two tracks, the Merit-Based Incentive Payment System …
Uncertainty Remains in the Marketplace
On April 13, 2017 CMS issued its final rule designed to make the ACA Marketplaces more appealing to insurers. Under this final rule, starting for the 2018 plan year: The annual Open Enrollment Period will be shortened from 3 months to 6 weeks States will have full authority to determine if an insurer’s network has …